Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/111394
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Type: Journal article
Title: Geo-epidemiology of temporal artery biopsy-positive giant cell arteritis in Australia and New Zealand: is there a seasonal influence?
Author: De Smit, E.
Clarke, L.
Sanfilippo, P.
Merriman, T.
Brown, M.
Hill, C.
Hewitt, A.
Citation: RMD Open, 2017; 3(2):e000531-1-e000531-8
Publisher: BMJ Journals
Issue Date: 2017
ISSN: 2056-5933
2056-5933
Statement of
Responsibility: 
Elisabeth De Smit, Linda Clarke, Paul G Sanfilippo, Tony R Merriman, Matthew A Brown, Catherine L Hill and Alex W Hewitt, Giant Cell Arteritis Pathology Network
Abstract: Objective: Previous studies, although inconclusive, have suggested possible associations of environmental risk factors with the development of giant cell arteritis (GCA). We aim to investigate seasonal influence on the incidence of GCA across Australia and New Zealand. Methods: In establishing an international study to investigate the molecular aetiology of GCA, archived temporal artery biopsy (TAB) specimens primarily from Australia and New Zealand were obtained. Demographic details including age, sex and date of TAB were collected from collaborating pathology departments. The season in which GCA was diagnosed was determined and compared with previous reports investigating the association between environmental risk factors and GCA. Results: Our study comprises data from 2224 TAB-positive patients with GCA; 2099 of which were from patients in Australia and New Zealand. The mean age at time of diagnosis was 76.4 years of age. The female-to-male ratio was 2.2:1. We noted equal distribution of the incidence rate across all four seasons (530–580 cases diagnosed every quarter). Statistical analysis of seasonal variation by Poisson regression and cosinor methods showed no incidence preponderance across seasons. Our results do not support a seasonal component contributing to the onset of disease. Our literature search identifies no consistent environmental risk factor in association with GCA. Conclusion: This is the largest GCA data set reported outside of Europe. Our results demonstrate equal distribution of the incidence rate across all four seasons. In contrast to some earlier reports, we did not identify evidence of a seasonal component contributing to the onset of disease. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Keywords: environment
epidemiology
geography
giant cell arteritis
latitude
risk factor
seasons
temporal arteritis
temporal artery biopsy
Rights: © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
DOI: 10.1136/rmdopen-2017-000531
Grant ID: NHMRC
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